Neurodevelopment of Critical ILL Neonates at the Age of 12 Months.

Abstract

Critically ill neonates who survive are often left with dire consequences. Cerebral palsy, other neurological and motor deficiencies, intellectual disability, and various degrees of cognitive and behavioral deficiencies all result from neonatal critical diseases. We investigated psychomotor development in 20 children with hypoxic-ischemic encephalopathy (HIE), and as newborns often have multiple comorbidities, the following as well: HIE with respiratory distress syndrome (RDS), infections, hypo and hyperglycemia and hypocalcemia. Socio-demographic, pregnancy and delivery data together with appropriate staging tools in determining the severity of HIE or RDS were utilized in this evaluation. In addition, a physical examination, Apgar score, blood gas analyses, biochemical, microbiological and ultrasound data were also part of this study. A child's psychomotor development includes four main areas: motor skills, language, cognition, and social relationships. The Griffiths Mental Development Scale (GMDS) compares different developmental domains and enables early diagnosis of deficiencies and guidance for appropriate early intervention. Six children (30%) were diagnosed with cerebral palsy. GMDS showed that at the age of one year, 50% of the children had typical development, 5% had mild disability, 20% moderate disability and 25% had severe disability. The severity of HIE, Apgar score, weak muscle tone, seizures, disturbances in glucose homeostasis, comorbidities (sepsis, infection) statistically significantly impacted the outcome. Studies with a greater number of patients are needed to support these findings and enable early interventions to avoid severe consequences of critical illness neonates.